Bovine bone graft inlay versus onlay for mandibular ridge augmentation (randomized clinical trial)

Augmentation of the alveolar ridge became the backbone for treating the atrophic alveolar ridge. Several augmentation techniques have been proposed for this to compensate for changes in anatomy and ridge morphology and achieve aesthetic and biomechanical outcomes for the implant treatment plane. Increasing bone volume enhances implant stability and long-term implant survival.

To compare the efficacy of bovine block inlay graft vs. Onlay graft for 3D alveolar ridge augmentation in the mandible.

Twenty-four patients were randomly assigned to the Inlay and Onlay groups. The mandibular ridge was separated for the Inlay group, and a bovine bone block was placed in the space and secured with screws and a microtitanium plate. On a particulate bovine graft, the defect site was decorated and pre-adapted titanium was placed on a 3D module secured with titanium screws for the Onlay group. ONDEMOND software was used to estimate bone volume and evaluate bone density from cone beam computed tomography images, obtained both before and 6 months after surgery.

A statistically significantly greater horizontal bone gain was observed in the Onlay group compared to the Inlay group (p = .033), while no statistically significant difference was found in vertical bone gain (p = .606).

A comparable amount of vertical bone gain was observed between the two techniques, whereas the Onlay approach was associated with a statistically significantly greater horizontal bone gain.

This randomized clinical trial was retrospectively registered at the Pan African Clinical Trial Registry (PACTR202412832590378).